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1.
Cad. Saúde Pública (Online) ; 38(1): e00287820, 2022. tab
Article in English | LILACS | ID: biblio-1355982

ABSTRACT

This study aims to investigate factors associated with serum 25-hydroxyvitamin D [25(OH)D] concentration in Brazilian adults considering sociodemographic and lifestyle factors, as well as vitamin D-related single nucleotide polymorphisms (SNPs). This is a cross-sectional study (n = 491; 34-79y; 251 women), nested within a prospective cohort (Pró-Saúde Study). Associations between serum 25(OH)D and sociodemographic characteristics, diet, use of supplement, physical activity, season of blood collection, body fat, skin type, sun exposure index, and SNPs CYP2R1-rs10741657 and GC-rs2282679 were explored by multiple linear regression. The prevalence of serum 25(OH)D < 50nmol/L was 55%. Serum 25(OH)D was lower among women (β = -4.38; 95%CI: -8.02; -0.74), those with higher visceral fat (β = -4.02; 95%CI: -5.92; -2.12), and those with AC and CC genotypes for GC-rs2282679 (β = -6.84; 95%CI: -10.09; -3.59; β = -10.63; 95%CI: -17.52; -3.74, respectively). Factors directly associated with serum 25(OH)D included summer (β = 20.14; 95%CI: 14.38; 25.90), intermediate skin type (β = 6.16; 95%CI: 2.52; 9.80), higher sun exposure (β = 0.49; 95%CI: 0.22; 0.75), vitamin D intake (β = 0.48; 95%CI: 0.03; 0.93), and physical activity (β = 4.65; 95%CI: 1.54; 7.76). Besides physical activity, diet, and sun exposure, non-modifiable factors, such as GC genotypes must be considered when evaluating vitamin D insufficiency in mixed-race populations. Moreover, high visceral fat in association with poorer vitamin D status deserve attention given that both conditions are unfavorably related with chronic and acute health outcomes.


Este estudo teve como objetivo investigar fatores associados com as concentrações séricas de 25-hidroxivitamina [25(OH)D] em adultos brasileiros de acordo com fatores sociodemográficos e de estilo de vida, assim como de polimorfismos de nucleotídeo único (SNPs) relacionados à vitamina D. Este é um estudo transversal (n = 491; 34-79 anos; 251 mulheres) aninhado em uma coorte prospectiva (Estudo Pró-Saúde). Associações entre a 25(OH)D sérica e características sociodemográficas, consumo alimentar, uso de suplementos, atividade física, estação do ano na coleta da amostra de sangue, gordura corporal, fototipo de pele, índice de exposição solar e SNPs CYP2R1-rs10741657 e GC-rs2282679, explorados por regressão multilinear. A prevalência de 25(OH)D sérica < 50nmol/L foi 55%. A concentração sérica de 25(OH)D foi menor entre mulheres (β = -4,38; IC95%: -8,02; -0,74), indivíduos com mais gordura visceral (β = -4,02; IC95%: -5,92; -2,12) e genótipos AC e CC para GC-rs2282679 (β = -6,84; IC95%: -10,09; -3,59 e β = -10,63; IC95%: -17,52; -3,74, respectivamente). Os fatores associados diretamente à 25(OH)D sérica incluíram os meses de verão (β = 20,14; IC95%: 14,38; 25,90), fototipo intermediário (β = 6,16; IC95%: 2,52; 9,80), maior exposição solar (β = 0,49; IC95%: 0,22; 0,75), ingestão de vitamina D (β = 0,48; IC95%: 0,03; 0,93) e atividade física (β = 4,65; IC95%: 1,54; 7,76). Além de atividade física, dieta e exposição solar, fatores não modificáveis, tais como variantes do gene GC devem ser considerados na avaliação da deficiência de vitamina D em populações miscigenadas. Além disso, merece atenção a associação entre a gordura visceral elevada e o pior estado de vitamina D, uma vez que ambas as condições implicam em desfechos de saúde desfavoráveis, tanto crônicos quanto agudos.


Nuestro objetivo fue investigar factores asociados con la concentración sérica 25-hidroxivitamina D [25(OH)D] en adultos brasileños, considerando factores sociodemográficos y de vida, así como también los polimorfismos de nucleótido único relacionados con la vitamina D (SNPs). Se trata de un estudio transversal (n = 491; 34-79 años; 251 mujeres), anidado dentro de una cohorte prospectiva (Estudio Pro-Salud). Se investigaron las asociaciones entre concentración sérica 25(OH)D y características sociodemográficas, ingesta alimentaria, uso de suplementos, actividad física, estación del año de recogida de muestras de sangre, grasa corporal, tipo de piel, índice de exposición al sol, y SNPs CYP2R1-rs10741657 y GC-rs2282679 mediante una regresión múltiple lineal. La prevalencia sérica 25(OH)D < 50nmol/L fue 55%. La 25(OH)D sérica fue menor entre las mujeres (β = -4,38; IC95%: -8,02; -0,74), quienes tenían alta grasa visceral (β = -4,02; IC95%: -5,92; -2,12), genotipos AC y CC para GC-rs2282679 (β = -6,84; IC95%: -10,09; -3,59 y β = -10,63; IC95%: -17,52; -3,74, respectivamente). Los factores directamente asociados con la concentración sérica 25(OH)D incluyeron verano (β = 20,14; IC95%: 14,38; 25,90), tipo de piel intermedia (β = 6,16; IC95%: 2,52; 9,80), más alta exposición al sol (β = 0,49; IC95%: 0,22; 0,75), toma de vitamina D (β = 0,48; IC95%: 0,03; 0,93) y actividad física (β = 4,65; IC95%: 1,54; 7,76). Además de la actividad física, dieta y exposición al sol, los factores no modificables, tales como genotipos GC, necesitan tenerse en cuenta cuando se está evaluando la insuficiencia de vitamina D en poblaciones mestizas. Asimismo, las implicaciones de la asociación de una alta grasa visceral con un estatus más pobre de vitamina D merece que se le preste atención, puesto que ambas condiciones de salud están relacionadas desfavorablemente con resultados de salud graves y crónicos.


Subject(s)
Humans , Female , Adult , Vitamin D-Binding Protein/genetics , Vitamin D Deficiency/genetics , Vitamin D Deficiency/epidemiology , Seasons , Vitamin D/analogs & derivatives , Brazil , Cross-Sectional Studies , Prospective Studies , Life Style
2.
Article in English | WPRIM | ID: wpr-922184

ABSTRACT

BACKGROUND@#Given the important repercussions that sociodemographic factors can have on physical activity, especially in the field of leisure, and cardiometabolic risk, it seems relevant to analyze the implications of these variables on the relationship between physical activity in leisure time (LTPA) and cardiometabolic risk. In this sense, the present study aims to verify the moderating role of biologic and socioeconomic factors in the relationship between LTPA and cardiometabolic risk in adolescents in southern Brazil.@*METHODS@#Cross-sectional study that included 1596 adolescents selected at random (58.2% girls), aged between 10 and 17 years. LTPA, biological and socioeconomic factors were assessed using a self-reported questionnaire and the cardiometabolic risk score (total cholesterol/HDL-c ratio, triglycerides, fasting glucose, systolic blood pressure, and waist circumference, considering the participant's age and sex) was included as an outcome. Associations and moderations were tested by multiple linear regression models.@*RESULTS@#It was observed a positive interaction of LTPA and sex (p = 0.048) and LTPA and school system (p = 0.037), and negative interaction of LTPA and skin color (p = 0.040), indicating that these factors were moderators in the relationship between LTPA and clustered cardiometabolic risk score (cMetS) in adolescents. A reduction in cardiometabolic risk was observed according to the increase in weekly minutes of LTPA among boys, non-white adolescents, and students from municipal schools.@*CONCLUSIONS@#The association between LTPA and cardiometabolic risk was moderated by sex, skin color, and school system in adolescents from southern Brazil.


Subject(s)
Adolescent , Age Factors , Brazil/epidemiology , Cardiometabolic Risk Factors , Child , Cross-Sectional Studies , Effect Modifier, Epidemiologic , Exercise , Female , Humans , Leisure Activities , Male , Sex Factors , Skin Pigmentation , Socioeconomic Factors
3.
Surg. cosmet. dermatol. (Impr.) ; 12(4 S1): 39-42, fev.-nov. 2020.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1367301

ABSTRACT

A doença de Dowling-Degos (DDD) é uma genodermatose rara, caracterizada principalmente por hiperpigmentação reticular progressiva de áreas flexurais, que pode estar associada a um grande espectro de lesões benignas e neoplasias cutâneas. Pode ocasionar prejuízo psicossocial devido ao potencial de deformidade das lesões e dano estético significativo. Apresentamos dois casos de pacientes, ambos do sexo masculino, com máculas hipercrômicas, múltiplos comedões, cistos epidérmicos, cicatrizes cribriformes em: face, região cervical, dorso, tórax anterior, axilas e região genital, além de tumorações desfigurantes, características da DDD


Dowling-Degos disease (DDD) is a rare genodermatosis. Progressive reticular hyperpigmentation of flexural areas mainly characterizes the disease, which may be associated with a large spectrum of benign lesions and cutaneous neoplasms. It may cause psychosocial impairment due to the deformity caused by the lesions with significant aesthetic damage. We present two cases of male patients with hyperchromic macules, multiple comedones, epidermal cysts, cribriform scars on the face, cervical region, dorsum, anterior thorax, armpits, genital region, and disfiguring tumors, characteristic of DDD

4.
Einstein (Säo Paulo) ; 18: eAO5432, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133775

ABSTRACT

ABSTRACT Objective: To describe the morphology of the supra- and infraumbilical linea nigra in puerperal women. Methods: The study was conducted from September 2017 to April 2018, and included 157 puerperal women admitted for childbirth care at the Obstetrics Department of a public maternity hospital of the city of São Paulo (SP), Brazil. The abdomen of subjects was photographed on the first or second day postpartum, with the patient lying symmetrically in dorsal decubitus at a standardized distance. Contrast was slightly adjusted and the morphological pattern of supra and infraumbilical linea nigra in the proximity of the umbilical scar was characterized. The images were independently analyzed by two researchers and only the matching results from both observers were used. Results: Of the 157 observed cases, 139 (88.5%) images provided concordant results between the two researchers. Excluding 41 cases of absence or poor definition of the linea nigra, 98 images were analyzed. Supra- and infraumbilical linea nigra were analyzed separately and classified according to three directions (left, center and right of the umbilical scar). The combination of the supra- and infraumbilical images resulted in the formation of nine distinct patterns, being the most prevalent, in primiparous (72.2%) and multiparous women (50.0%), and the authors named as "anticlockwise spiralization of the linea nigra". Conclusion: The analysis of supra- and infraumbilical linea nigra in puerperal women showed a predominance of what the authors named "anti-clockwise spiralization of the linea nigra sign".


RESUMO Objetivo: Descrever a morfologia da linea nigra supra e infraumbilical em puérperas. Métodos: O estudo foi realizado no período de setembro de 2017 a abril de 2018 e incluiu 157 puérperas admitidas para o parto no Serviço de Obstetrícia de uma maternidade pública da cidade de São Paulo (SP). O abdome das pacientes foi fotografado no primeiro ou segundo dia pós-parto, com a paciente deitada simetricamente em decúbito dorsal a uma distância padronizada. O contraste foi ligeiramente ajustado, e o padrão morfológico da linea nigra supra e infraumbilical na proximidade da cicatriz umbilical foi caracterizado. As imagens foram analisadas independentemente por dois pesquisadores, e apenas os resultados concordantes dos dois observadores foram utilizados. Resultados: Dos 157 casos observados, 139 (88,5%) imagens apresentaram resultados concordantes entre os dois pesquisadores. Excluindo 41 casos de ausência ou má definição da linea nigra, 98 imagens foram analisadas. As linea nigra supra e infraumbilicais foram analisadas separadamente e classificadas de acordo com três direções (esquerda, centro e direita da cicatriz umbilical). A combinação das imagens supra e infraumbilicais resultou na formação de nove padrões distintos, sendo os mais prevalentes nas primíparas (72,2%) e multíparas (50,0%), o que os autores denominaram "espiralamento anti-horário da linea nigra". Conclusão: A análise das linea nigra supra e infraumbilical em puérperas mostrou predominância do que os autores denominaram "sinal do espiralamento anti-horário da linea nigra".


Subject(s)
Humans , Female , Skin/pathology , Umbilicus , Pregnancy/physiology , Skin Pigmentation , Hyperpigmentation/diagnosis , Brazil
5.
Autops. Case Rep ; 10(4): e2020197, 2020. tab, graf
Article in English | LILACS | ID: biblio-1131843

ABSTRACT

Ochronosis is a cutaneous disorder caused by the accumulation of phenols, either endogenously as homogentisic acid in patients with alkaptonuria (autosomal recessive disorder with deficiency of the enzyme homogentisic acid oxidase), or exogenously in patients using phenol products such as topical creams containing hydroquinone or the intramuscular application of antimalarial drugs. Exogenous ochronosis (EO) typically affects the face and was reported in patients with dark skin such as Black South Africans or Hispanics who use skin-lightening products containing hydroquinone for extended periods. Recently more cases have been reported worldwide even in patients with lighter skin tones, to include Eastern Indians, Asians, and Europeans. However, just 39 cases of EO have been reported in the US literature from 1983 to 2020. Here we present two cases; a 69 and a 45-year-old female who were seen for melasma, given hydroquinone 4% cream daily and tretinoin 0.05%. Both patients noticed brown spots on their cheeks, which progressively enlarged and darkened in color. The diagnosis of ochronosis was confirmed by characteristic histopathological features on the punch biopsy. Unfortunately, neither patient responded to multiple treatments (to include, tazarotene 0.1% gel and pimecrolimus ointment, topical corticosteroids, and avoidance of hydroquinone containing products). We also present a case of classic (endogenous) ochronosis in a patient with alkaptonuria to picture the histological similarities of these two entities. EO is an important clinical consideration because early diagnosis and treatment may offer the best outcome for this notoriously refractory clinical diagnosis.


Subject(s)
Humans , Female , Middle Aged , Aged , Skin Pigmentation , Skin Cream/adverse effects , Ochronosis/diagnosis , Phenols , Skin , Skin Diseases , Cheek , Alkaptonuria , Homogentisic Acid
6.
An. bras. dermatol ; 94(4): 434-441, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038295

ABSTRACT

Abstract: Background: In-vitro studies showed that Leucine-rich glioma inactivated 3 (LGI3) is a keratinocyte-derived cytokine that stimulates melanin synthesis and is increased after ultra violet B (UVB) irradiation. So, we postulated that LGI3 may be involved in vitiligo aetiopathogenesis and may participate in narrow band ultra violet B (NB-UVB) induced pigmentation in vitiligo. Objectives: To assess this hypothesis, lesional LGI3 immunohistochemical expression of vitiligo patients before and after NB-UVB phototherapy was studied, and its correlation with repigmentation was evaluated. Methods: Forty vitiligo patients and 20 age, sex, and skin phenotype-matched controls were enrolled. Patients were treated with NB-UVB thrice weekly for 12 weeks. VASI score was evaluated before and after NB-UVB sessions. For vitiligo patients, baseline LGI3 immunohistochemical staining was estimated, and compared to that of controls and to its post-treatment data in those patients. Results: Baseline LGI3 immunohistochemical studied parameters (expression, intensity, percentage and H score) were significantly lower in vitiligo cases than controls (p=0.003, 0.013, 0.001 and 0.001 respectively). After 12 weeks of NB-UVB phototherapy, these LGI3 immunohistochemical parameters were up-regulated and became comparable to that of controls (p >0.05 for all). There was a significant positive correlation between the improvement of both VASI score and LGI3 H score mean values (r=-0.349 , p=0.027). Study limitations: Small number of investigated subjects. Conclusions: Decreased LGI3 protein may play an active role in vitiligo pathogenesis and its up-regulation after NB-UVB phototherapy, may actively participate in NB-UVB photo-induced melanogenesis.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Young Adult , Ultraviolet Therapy/methods , Vitiligo/pathology , Vitiligo/radiotherapy , Proteins/analysis , Cytokines/analysis , Reference Values , Time Factors , Severity of Illness Index , Immunohistochemistry , Case-Control Studies , Keratinocytes/radiation effects , Treatment Outcome , Statistics, Nonparametric , Melanocytes/radiation effects
7.
Colomb. med ; 50(2): 115-127, May-June 2019. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1055980

ABSTRACT

Abstract Introduction: High blood pressure (HBP) is the main cardiovascular risk factor, it is more prevalent in the older adult population, and the prevalence can vary between ethnic groups. Objective: To estimate the prevalence of HBP, knowledge, treatment and control in population aged ≥60 years, resident in Colombia, according to their ethnic condition. Methods: Population sample selected by multistage sampling. Ethnicity was defined based on skin color. HBP was defined as systolic blood pressure ≥140, and/or diastolic blood pressure ≥90 mm Hg, and/or the participants' self-report. Controlled HBP at a blood pressure value <140/90, knowledge and treatment were identified by self-report. Results: 23,694 adults aged ≥60 years were included, of which 54.5%, 34.5% and 10.9% were respectively identified as having light, medium or dark skin color; 54.5% were women, and 78.1% resided in urban areas. The standardized prevalence of HBP, by age, was 57.7% (95% CI: 55.2-60.2); 51.4% (95% CI: 47.3-55.5), in men; and 62.9% (60.9-64.9), in women. The standardized prevalence for light, medium and dark skin in men was 53.2% (95% CI: 48.7-57.7), 49.6% (44.5-54.7), and 49.4% (95% CI: 41.0-57.8) respectively; and in women was 62.5% (95% CI: 60.5-64 , 5), 61.7% (95% CI: 57.8-65.6), and 69.9% (95% CI: 63.6-76.2) respectively. 98% of the population received treatment, and 93.9% were aware of HBP diagnosis. 42.5% of men and 55.5% of women with HBP were under control. Only 21.8% performed regular physical activity. Conclusion: Half of the adult population aged over 60 years suffers from HBP; the prevalence is higher in women particularly in dark-skinned women. It is necessary to develop policies to increase physical activity in the elderly.


Resumen Introducción: La presión arterial elevada (PAE) es el principal de factor de riesgo cardiovascular, es más prevalente en población adulta mayor y la prevalencia puede variar entre etnias. Objetivo: Estimar la prevalencia de PAE, conocimiento, tratamiento y control en población ≥60 años residente en Colombia de acuerdo con su condición étnica. Métodos: Muestra poblacional seleccionada mediante un muestreo multietápico. La etnia se definió con base en el color de piel. La PAE se definió como presión arterial sistólica ≥140 y/o presión arterial diastólica ≥90 mm Hg y/o el autoreporte del participante. La PAE controlada a un valor de presión arterial <140/90, el conocimiento y el tratamiento se identificaron por autoreporte. Resultados: Fueron incluidos 23,694 adultos con edad ≥ 60 años, de los cuales, 54.5%, 34.5% y 10.9% se identificaron con color de piel claro, medio u oscuro respectivamente, El 54.5%, eran mujeres y el 78.1% residía en zona urbana, La prevalencia estandarizada por edad de PAE fue 57,7% (IC 95%: 55.2-60.2), 51.4% (IC 95%: 4.3-55.5) en hombres y 62.9% (60.9-64.9) en mujeres, La prevalencia estandarizada en hombres claros, medios y oscuros fue 53.2%(IC 95%: 48.7-57.7), 49.6% (44.5-54.7) y 49.4% (IC 95%: 41.0-57.8) respectivamente y en mujeres 62.5% (IC 95%: 60.5-64.5), 61.7% (IC 95%: 57.8-65.6) y 69.9% (IC 95%: 63.6-76.2) respectivamente, El 98% de la población recibía tratamiento y el 93.9% conocía el diagnóstico de PAE, El 42.5% de los hombres y el 55.5% de las mujeres se encontraban con PAE controlada, El 21.8% realizaba actividad física regularmente. Conclusión: La mitad de la población adulta mayor a 60 años sufre PAE, mayor prevalencia en mujeres y particularmente mujeres oscuras. Se requiere desarrollar políticas para incrementar la actividad física en el adulto mayor.

8.
Rev. bras. oftalmol ; 76(4): 202-206, July-Aug. 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-899070

ABSTRACT

Resumo Relato de um caso clínico de Xeroderma Pigmentoso com carcinoma espinocelular de conjuntiva bilateral que apresentou regressão importante das dimensões tumorais com o uso de Interferon alfa-2b tópico. Relato de caso: Paciente feminina com Xeroderma Pigmentoso em estágio avançado, com ausência de pele sadia, tendo sido submetida a cerca de 60 exéreses de lesões de pele malignas. A paciente compareceu com tumoração conjuntival em ambos os olhos, correspondendo a carcinoma espinocelular de conjuntiva e neoplasia intraepitelial de conjuntiva em olho esquerdo. Devido as dificuldades cirúrgicas, alta taxa de recidiva e elevada probabilidade de formação de simbléfaro foi-se iniciado terapêutica com Interferon alfa-2beta 1.000.000 unidades tópico, obtendo-se bons resultados com importante regressão do tamanho da lesão e resolução dos sintomas. Conclusão: O uso tópico de interferon alfa-2beta em neoplasia escamosa de conjuntiva, mostrou-se uma boa opção terapêutica em situações de elevado risco cirúrgico e de complicações pós operatórias.


Abstract Report of a case of xeroderma pigmentosum with squamous cell carcinoma of bilateral conjunctiva that showed a significant regression in tumor size with the use of interferon alfa-2b topic. Case report: Female patient with Xeroderma pigmentosum in an advanced stage, with no healthy skin, having been subjected to about 60 excisions of malignant skin lesions. The patient appeared with conjunctival tumors in both eyes, corresponding to squamous cell carcinoma of the conjunctiva. Due to surgical difficulties, high relapse rate and high probability of symblepharon formation, therapy was started with interferon alpha 2beta 1,000,000 topic units, obtaining good results with a significant decrease in lesion size and resolution of symptoms. Conclusion: Topical use of alpha-interferon in 2beta squamous neoplasia of the conjunctiva proved to be a good therapeutic option for high surgical risk and situations of postoperative complications.


Subject(s)
Humans , Female , Adult , Xeroderma Pigmentosum/complications , Carcinoma in Situ , Carcinoma, Squamous Cell , Conjunctival Neoplasms/diagnosis , Conjunctival Neoplasms/pathology , Conjunctival Neoplasms/drug therapy , Administration, Ophthalmic , Interferon alpha-2/therapeutic use
9.
An. bras. dermatol ; 91(5,supl.1): 54-56, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837925

ABSTRACT

Abstract Phacomatosis pigmentovascularis is a rare syndrome, defined as the simultaneous presence of vascular nevus and melanocytic nevus in the same patient. We report the case of a 53-year-old woman presented with dermal melanosis and extensive vascular nevus, which match the typical manifestations of phakomatosis pigmetovascularis of cesioflammea type, according to Happle's classification. The rare occurrence of this genodermatosis and the clinical exuberance of the skin lesions motivated this case report.


Subject(s)
Humans , Female , Middle Aged , Skin Neoplasms/pathology , Neurocutaneous Syndromes/pathology , Melanosis/pathology , Nevus, Pigmented/pathology , Skin/pathology , Port-Wine Stain/pathology , Rare Diseases/pathology
10.
Colomb. med ; 47(3): 160-166, Sept. 2016. tab
Article in English | LILACS | ID: biblio-828602

ABSTRACT

Abstract Objective: To establish the impact the chronic kidney disease stage has in the native vitamin D levels in patients not undergoing dialysis treatment. Methods: A study performed in Manizales, Colombia, a city located 2,200 meters above sea level, without important stational variations. Patients with 18 years of age or more, with chronic kidney disease stages 2 to 5 and not undergoing dialysis treatment were recruited for this study. Demographic and anthropometric variations were evaluated as well as solar exposure, CKD etiology and laboratory variables related to bone and mineral diseases. For each CKD clinical stage, correlations were evaluated for vitamin D levels, laboratory results for bone and mineral diseases, solar exposure and ethnicity. Results: Three hundred thirty-three patients were evaluated with a median age of 71 years, most of them mestizo (71%), 173 were women. The main CKD etiology was hypertensive nephropathy (32.2%). 21.1% of patients had normal vitamin D levels, 70.1% were within insufficient range and 8.8% were in deficit. A negative correlation was found between the levels of vitamin 25 (OH) D and the values for: creatinine, phosphorous, calcium x phosphorous product, PTH, 24 hours urine protein and BMI. A positive relationship was found for calcium and albumin. Positive significant statistical correlation was found for vitamin 25(OH) D levels and solar exposure for stages 3b and 4 of CKD. Conclusions: It is common to find low levels of vitamin 25(OH) D in patients with CKD; these can contribute to the appearance of secondary hyperparathyroidism.


Resumen Objetivo: Establecer el impacto del estadio clínico en los niveles de vitamina D nativa en pacientes con enfermedad renal crónica (ERC) sin diálisis. Métodos: Estudio realizado en Manizales, Colombia, una ciudad tropical ubicada a 2,200 metros de altura sobre el nivel del mar, sin variaciones estacionales importantes a lo largo del año. Se incluyeron pacientes mayores de 18 años, con enfermedad renal crónica estadio 2 a 5 sin tratamiento dialítico. En ellos se evaluaron variables demográficas, antropométricas, grado de exposición solar, etiología de la enfermedad, y variables de laboratorio relacionadas con desórdenes óseos y minerales. Para cada estadío clínico se evaluó la correlación entre los niveles de vitamina D y los resultados de las pruebas de laboratorio relacionadas con desordenes óseos y minerales, exposición solar y etnia. Resultados: Se evaluaron 331 pacientes, con una edad media de 71 años, la mayoría mestizos (71%), 173 mujeres. La principal etiología de ERC fue nefropatía hipertensiva (33.2%). El 21.1% de los pacientes tenían niveles normales de vitamina D, fueron insuficientes en 70.1% y 8.8% en déficit. Se detectó correlación negativa, entre los niveles de vitamina 25(OH)D y los valores de creatinina, fósforo, producto calcio x fósforo, PTH, proteínas en orina de 24 horas e IMC. Correlación positiva para el calcio y la albumina. Se encontró significancia estadística positiva entre los niveles de vitamina 25(OH)D y la exposición solar para los estadios 3b y 4. Conclusiones: En pacientes con ERC es comun detectar bajos niveles de 25(OH)D, los cuales pueden contribuir a la generación de hiperparatiroidismo secundario.


Subject(s)
Renal Insufficiency, Chronic , Vitamin D , Calcitriol , Calcium , Hyperparathyroidism/blood , Hyperparathyroidism/diagnosis , Serial Cross-Sectional Studies
11.
Med. leg. Costa Rica ; 33(1): 170-174, ene.-mar. 2016. tab
Article in Spanish | LILACS | ID: lil-782678

ABSTRACT

La dermatosis cenicienta es una hipermelanosis idiopática con máculas de color azul grisáceo, que fue descrita inicialmente en El Salvador por Oswaldo Ramírez en 1957. Predomina en la población hispana de piel fototipo IV, siendo más común en adultos entre la segunda y tercera década de la vida. Aunque se desconoce la etiología, se han identificado factores predisponentes como la ingesta de nitrato de amonio, benzodiacepinas, exposición a pesticidas y fungicidas como clorotalonil, entre otros. A nivel histopatológico se visualiza degeneración e hiperpigmentación de la capa basal. Clínicamente, el tórax y las extremidades proximales son las áreas anatómicas comúnmente afectadas en esta enfermedad asintomática y de curso crónico. La historia clínica y el examen físico son la base del diagnóstico, así como una biopsia de piel de los bordes activos para confirmar el mismo. Aunque existen diversas opciones terapéuticas, solamente la clofazimina y la dapsona han mostrado eficacia en el tratamiento de la dermatosis cenicienta. El líquen plano pigmentado y la pigmentación macular eruptiva idiopática son dos de los principales diagnósticos diferenciales que el clínico debe considerar.


Ashy dermatoses is an idiopathic hypermelanosis with blue-gray macules, which was first described by Oswaldo Ramírez in El Salvador in 1957. It predominates in the Hispanic population with skin type IV, being most common in adults between the second and third decade of life. Although the etiology is unknown, predisposing factors have been identified as the intake of ammonium nitrate, benzodiazepines, exposure to pesticides and fungicides such as chlorothalonil, etc. Degeneration and hyperpigmentation of the basal layer is the main histopathologycal characteristics. Clinically, the chest and the proximal extremities are the anatomical areas commonly affected in this asymptomatic disease with chronic course. The clinical history and the physical examination are the basis of diagnosis, the biopsy of the skin active borders confirms it. Although there are several treatment options, only dapsone and clofazimine have shown efficacy in the ashy dermatosis treatment. Lichen planus pigmentosus and idiopathic eruptive macular pigmentation are two of the main differential diagnoses, the clinician should consider.


Subject(s)
Humans , Clofazimine , Erythema , Hyperpigmentation , Skin Diseases , Skin Pigmentation
12.
Chinese Journal of Dermatology ; (12): 697-701, 2016.
Article in Chinese | WPRIM | ID: wpr-503777

ABSTRACT

Objective To investigate skin manifestations and comorbidities of chronic arsenicosis due to conta?minated drinking water, and to explore their possible risk factors. Methods Data about demographic characteristics, skin manifestations and comorbidities were collected from 95 patients with chronic arsenicosis due to contaminated drinking water in Inner Mongolia, and retrospectively analyzed. A logistic regression model was established to analyze associations of skin manifestations and comorbidities with patients′ gender, age, age at onset of drinking of arsenic?contaminated water, arsenic concentrations in water and duration of arsenic exposure. Results Among the 95 patients, 77 had hyperpigmentation, 75 hypopigmentation, 93 palmoplantar keratoderma, 27 skin cancer, and 8 multiple skin cancer. Five patients were complicated by tuberculosis, 15 by hypertension, 2 by rheumatoid arthritis, 4 by cerebral infarction, 7 by coronary heart diseases, 3 by internal malignancy, 6 by hepatic cirrhosis and 2 by anemia. Logistic regression analysis revealed a significant correlation between hyperpigmentation and arsenic concentrations in water(OR=0.32, 95%CI=0.10-0.98;ORadjusted=0.27, 95%CI=0.08-0.90), between occurrence of hepatic cirrhosis and arsenic concentrations in water (OR=24.67, 95%CI=2.69-226.57;ORadjusted=22.51, 95%CI=2.38-213.11), and between occurrence of coronary heart diseases and duration of arsenic exposure(OR=6.41, 95%CI=1.09-37.88;ORadjusted=8.55, 95%CI=1.21-60.41). Conclusions There is a high incidence of aberrant pigment metabolism, palmoplantar keratoderma and skin cancer in patients with chronic arsenicosis due to contaminated drinking water. Different arsenic concentrations in water and duration of arsenic exposure seem to have different influences on the human body.

13.
An. bras. dermatol ; 90(6): 822-826, Nov.-Dec. 2015. tab
Article in English | LILACS | ID: lil-769520

ABSTRACT

Abstract: BACKGROUND: During pregnancy there is immunological, metabolic, endocrine and vascular changes responsible for physiological and pathological skin changes. OBJECTIVES: determine the prevalence of specific physiological changes and pregnancy, comparing the period of gestation of their appearances and compare type of prenatal care as the skin changes. METHODS: A cross-sectional study with 905 pregnant women. RESULTS: The prevalence of physiological skin changes was 88.95% and the most common was pigment. The prevalence of specific dermatoses was 8.72% and atopic eruption was the most common. CONCLUSION: Physiological changes were seen more in the 3rd quarter, as well as the specific dermatoses. No statistical difference in prenatal low risk compared to high risk was observed, whereas the cutaneous physiological changes and specific pregnancy dermatoses.


Subject(s)
Adolescent , Adult , Female , Humans , Middle Aged , Pregnancy , Young Adult , Pregnancy, High-Risk , Skin Diseases/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Gestational Age , Prevalence , Risk Assessment , Risk Factors , Skin Pigmentation
14.
An. bras. dermatol ; 90(4): 494-503, July-Aug. 2015. tab, ilus
Article in English | LILACS | ID: lil-759199

ABSTRACT

AbstractBACKGROUND:Peri-orbital dark circles are a cosmetic concern worldwide, and have been attributed to hyperpigmentation from allergy or atopic dermatitis, blood stasis, structural shadowing effects, and a thin epidermis/dermis under the eye. It is of interest to better understand lifestyle and demographic risk factors and the relative impact of melanin, blood and epidermal/dermal factors on the severity of Peri-orbital dark circles.OBJECTIVE:To compare by non-invasive imaging the impact of biological factors to a visual grading scale for Peri-orbital dark circles, and test the correlation of various demographic factors with Peri-orbital dark circles.METHODS:Subjects completed a lifestyle and health survey, and Peri-orbital dark circles severity was evaluated using standardized photographs. Hyperspectral image analysis was used to assess the contributions of melanin, blood volume, degree of blood oxygen saturation, and dermal scattering.RESULTS:Family history was the most significant risk factor for Peri-orbital dark circles. The average age of onset was 24 years, and earlier onset correlated with higher severity scores. Asthma was significantly associated with Peri-orbital dark circles scores, but self-reported allergy was not. In this study, sleep was not correlated with Peri-orbital dark circles scores. Hyperspectral imaging indicated that melanin was the dominant correlate for Peri-orbital dark circles severity, while oxygen saturation was secondary. The difference between under-eye and cheek measurements for ΔL*and ΔE* were the most significant instrumental parameters correlated with visual assessment of Peri-orbital dark circles severity.CONCLUSION:Although typically associated with lack of sleep, risk of Peri-orbital dark circles is primarily hereditary. The main factors contributing to the appearance of Peri-orbital dark circles are melanin and (deoxygenated) blood.


Subject(s)
Adolescent , Adult , Aged , Female , Humans , Middle Aged , Young Adult , Eye Diseases/etiology , Facial Dermatoses/etiology , Hyperpigmentation/etiology , Life Style , Age Distribution , Age Factors , Brazil , Eye Diseases/physiopathology , Facial Dermatoses/physiopathology , Hyperpigmentation/physiopathology , Melanins/analysis , Orbit , Oxygen/blood , Risk Factors , Severity of Illness Index , Spectrophotometry , Statistics, Nonparametric , Skin/physiopathology
15.
An. bras. dermatol ; 89(5): 771-782, Sep-Oct/2014. tab, graf
Article in English | LILACS | ID: lil-720785

ABSTRACT

Melasma is a chronic acquired hypermelanosis of the skin, characterized by irregular brown macules symmetrically distributed on sun-exposed areas of the body, particularly on the face. It is a common cause of demand for dermatological care that affects mainly women (especially during the menacme), and more pigmented phenotypes (Fitzpatrick skin types III-V). Due to its frequent facial involvement, the disease has an impact on the quality of life of patients. Its pathogeny is not yet completely understood, although there are some known triggering factors such as sun exposure, pregnancy, sexual hormones, inflammatory processes of the skin, use of cosmetics, steroids, and photosensitizing drugs. There is also a clear genetic predisposition, since over 40% of patients reported having relatives affected with the disease. In this manuscript, the authors discuss the main clinical and epidemiological aspects of melasma.


Subject(s)
Female , Humans , Male , Melanosis/epidemiology , Melanosis/etiology , Melanosis/pathology , Melanosis/physiopathology , Quality of Life , Risk Factors , Sex Factors , Skin/pathology
16.
Annals of Dermatology ; : 681-687, 2014.
Article in English | WPRIM | ID: wpr-209816

ABSTRACT

BACKGROUND: Over the last decade, the incidence of ultraviolet B (UVB)-related skin problems has increased. Oxidative stress caused by UVB induces the secretion of melanocyte growth and activating factors from keratinocytes, which results in the formation of cutaneous hyperpigmentation. Therefore, increasing the antioxidant abilities of skin cells is thought to be a beneficial strategy for the development of sunscreen agents. Superoxide dismutase 1 (SOD1) is an antioxidant enzyme that is known to exhibit antioxidant properties. OBJECTIVE: The purpose of this study was to investigate the effect of SOD1 on alpha-melanocyte stimulating hormone (alpha-MSH) and UVB-induced melanogenesis in B16F10 melanoma cells and HRM-2 melanin-possessing hairless mice. METHODS: The inhibitory effect of SOD1 on tyrosinase activity was evaluated in a cell-free system. Additional experiments were performed using B16F10 melanoma cells to demonstrate the effects of SOD1 in vitro, and HRM-2 melanin-possessing hairless mice were used to evaluate the antimelanogenic effects of SOD1 in vivo. RESULTS: We found that SOD1 inhibited melanin production in a dose-dependent manner without causing cytotoxicity in B16F10 melanoma cells. SOD1 did not inhibit tyrosinase activity under cell-free conditions. The results indicate that SOD1 may reduce pigmentation by an indirect, nonenzymatic mechanism. We also found that SOD1 decreased UVB-induced melanogenesis in HRM-2 melanin-possessing hairless mice, as visualized through hematoxylin and eosin staining and Fontana-Masson staining. CONCLUSION: Our results indicate that SOD1 has an inhibitory effect on alpha-MSH and UVB-induced melanogenesis, indicating that SOD1 may be a promising sunscreen agent.


Subject(s)
alpha-MSH , Animals , Cell-Free System , Eosine Yellowish-(YS) , Hematoxylin , Hyperpigmentation , Incidence , Keratinocytes , Melanins , Melanocytes , Melanoma , Mice , Mice, Hairless , Monophenol Monooxygenase , Oxidative Stress , Pigmentation , Skin Pigmentation , Skin , Superoxide Dismutase
17.
Chinese Journal of Dermatology ; (12): 667-668, 2014.
Article in Chinese | WPRIM | ID: wpr-455783

ABSTRACT

Objective To assess the clinical feature and diagnosis of diffuse hyperpigmentation with guttate depigmentation macules.Methods A retrospective study was carried out among 10 patients with diffuse hyperpigmentation with guttate depigmentation macules collected at the Institute of Dermatology,Chinese Academy of Medical Sciences and Peking Union Medical College from 2005 to 2012.The clinical manifestations,pathological findings and disease outcomes in these patients were analyzed.Results Of the 10 patients,6 were male,and 4 were female.The median age at onset was 7 years (range,4-25),and there were only 3 adult patients among these patients.None of the patients had a family history of pigmentary disturbance.Typical clinical manifestations included densely distributed,guttate hypopigmented macules arising on diffuse and uniform hyperpigmentation.Lesions could slowly spread over the body surface without the trend towards spontaneous regression.Pathologically,there was a slight increase in pigmentation of the epidermal basal layer,as well as melanins and melanophages scattered around blood vessels in the superficial dermis,with or without focal vacuolar degeneration of the basal cell layer.Conclusions Diffuse hyperpigmentation with guttate depigmentation macules,a rare pigmentary disturbance that clinically manifests as both hyperpigmentation and hypopigmentation and is pathologically characterized by postinflammatory hyperpigmentation,often affects children.Once the lesions occur,there is no trend towards regression.No effective treatment is available for this entity at present.

18.
Medisur ; 11(6): 696-700, dic. 2013.
Article in Spanish | LILACS-Express | LILACS | ID: lil-760230

ABSTRACT

El liquen plano presenta muchas variantes clínicas; una de ellas es el liquen plano pigmentoso, escasamente referida en la literatura médica, que al localizarse en los pliegues recibe el nombre de liquen plano pigmentoso inverso. Con el objetivo de comunicar en la literatura médica una rara variedad de liquen plano y el primero asociado a fármacos; se presenta el caso de una paciente de 51 años de edad y raza mestiza, latinoamericana atendida en el Servicio de Dermatología del Hospital Clínico Quirúrgico Celia Sánchez Manduley, de Granma, con lesiones pigmentadas en pliegues submamarios de varios años de evolución. El diagnóstico fue clínico, confirmado por elementos histopatológicos. Fueron descartadas algunas dermatosis con características muy similares. Se recogió el antecedente de tratamiento con captopril. El tratamiento con propóleos en crema resultó beneficioso.


Lichen planus has numerous clinical variants; one of them is lichen planus pigmentosus which is rarely mentioned in the medical literature. When located in the skin folds, it is known as lichen planus pigmentosus-inversus. In order to communicate a rare variant of lichen planus and its first presentation associated with drugs, we report the case of a 51 year-old mixed-race female patient from Latin America who was treated in the Department of Dermatology at the Celia Sanchez Manduley Clinical-Surgical Hospital in Granma. She presented with pigmented lesions in the inframammary folds that had evolved over several years. The clinical diagnosis was confirmed by histopathological elements. Some dermatoses with similar characteristics were dismissed. Treatment with propolis cream was beneficial.

19.
An. bras. dermatol ; 88(3): 413-416, jun. 2013. tab, graf
Article in English | LILACS | ID: lil-676223

ABSTRACT

A 70-year-old male rural worker was referred to our clinic with widespread grey pigmentation of the skin and nails. The condition had been asymptomatic for its entire duration (5 years). He reported past intranasal application of 10% Silver Vitellinate. A skin biopsy was performed and histology corroborated the clinical diagnosis of Argyria. This case represents a currently rare dermatological curiosity. Although silver colloids and salts have been withdrawn and/or banned by some drug surveillance agencies, they continue to be freely sold and unregulated as food supplements and as ingredients in alternative medicines, thereby risking the emergence of new cases of silver poisoning.


Um homem de 70 anos, trabalhador rural, foi referenciado à nossa consulta por dermatose assintomática, com 5 anos de evolução, caracterizada pela pigmentação acinzentada generalizada da pele, mais evidente em áreas fotoexpostas, e das lâminas ungueais. Relatava no passado o uso prolongado de Vitelinato de Prata a 10%, por via nasal. Foi efetuado exame histológico de biopsia cutânea que corroborou o diagnóstico clínico de Argiria. O caso representa uma curiosidade dermatológica, atualmente rara. Apesar de abandonados e/ou proibidos por algumas instituições de farmacovigilância, a prata coloidal e sais de prata continuam a ser comercializados como suplementos alimentares, como parte de medicinas alternativas e sem regulação, podendo fazer ressurgir os casos associados à toxicidade pela prata.


Subject(s)
Aged , Humans , Male , Argyria/pathology , Skin/pathology , Biopsy , Diagnosis, Differential , Eccrine Glands/pathology
20.
An. bras. dermatol ; 88(1): 76-83, fev. 2013. graf
Article in English | LILACS | ID: lil-667936

ABSTRACT

Skin pigmentation is an important human phenotypic trait whose regulation, in spite of recent advances, has not yet been fully understood. The pigment melanin is produced in melanosomes by melanocytes in a complex process called melanogenesis. The melanocyte interacts with endocrine, immune, inflammatory and central nervous systems, and its activity is also regulated by extrinsic factors such as ultraviolet radiation and drugs. We have carried out a review of the current understanding of intrinsic and extrinsic factors regulating skin pigmentation, the melanogenesis stages and related gene defects. We focused on melanocyte-keratinocyte interaction, activation of melanocortin type 1 receptor (MC1-R) by peptides (melanocyte-stimulating hormone and adrenocorticotropic hormone) resulting from proopiomelanocortin (POMC) cleavage, and mechanisms of ultraviolet-induced skin pigmentation. The identification and comprehension of the melanogenesis mechanism facilitate the understanding of the pathogenesis of pigmentation disorders and the development of potential therapeutic options.


A pigmentação da pele é um importante traço fenotípico do ser humano mas apesar dos recentes avanços a sua regulação não está ainda totalmente esclarecida. O pigmento melanina é produzido nos melanossomas pelos melanócitos, num processo complexo designado por melanogénese. O melanócito interatua com os sistemas endócrino, imunitário, inflamatório e nervoso central e a sua atividade é também regulada por fatores extrínsecos como a radiação ultravioleta e fármacos. Fizemos uma revisão do conhecimento atual sobre os fatores intrínsecos e extrínsecos reguladores da pigmentação cutânea, etapas da melanogénese e defeitos genéticos relacionados. Fizemos enfoque na interação melanócito-keratinócito, na ativação do receptor da melanocortina tipo 1 (MC1-R) pelos péptidos (hormona estimuladora do melanócito e hormona adrenocorticotrófica) resultantes da clivagem da proopiomelanocortina (POMC) e mecanismos da pigmentação induzida pela radiação ultravioleta. A identificação e compreensão dos mecanismos reguladores da pigmentação cutânea facilitam o conhecimento dos mecanismos patogénicos dos distúrbios da pigmentação e o desenvolvimento de potenciais opções terapêuticas.


Subject(s)
Humans , Keratinocytes/physiology , Melanins/biosynthesis , Melanocytes/physiology , Pigmentation Disorders/genetics , Skin Pigmentation/physiology , Adrenocorticotropic Hormone/physiology , Melanocyte-Stimulating Hormones/physiology , Receptor, Melanocortin, Type 1/physiology , Skin Pigmentation/radiation effects , Ultraviolet Rays/adverse effects
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